THE CARE REALITY CHECK

Canada’s provincial and federal penal systems spend tens of millions of dollars each year on health care, including funding for mental health services.

That’s how we began on April 15…….

Spokespeople for Correctional Service of Canada, and its counterparts in the provinces, have always insisted the men and women in their custody….and care….have the same access to the health care that is available to us all. What’s on paper tends to support the claim….practice and delivery say otherwise.

And, that’s how we left off last week.

So for example, how long do you wait to see your dentist when you need help? Would you be put off for more than a day? Would you be offered a speedy alternative if you couldn’t be accommodated immediately? Of course, that’s what you’d expect, and if it wasn’t forthcoming, one call and another dentist’s chair would be waiting, PDQ.

That’s how it is for us in the community, and that’s how it is for anyone and everyone who works in a jail or prison in Canada, and that’s how it is for anyone and everyone who works in a jail or prison health care unit in Canada.

That’s not how it is for inmates.

Inmates submit a request, a request that will pass through non-medical staff hands before it gets to the health care unit. Then, it’s a matter of waiting. Even ‘urgent’ requests can wait weeks for attention, if not longer.

As for dental maintenance programs which would lower costs to the system over time, is there any institution in the country that subscribes to such a service? We think not.

The attention here has focused on dental care because the discomfort of an aching tooth can easily be a worst-case scenario, aside from a life-threatening injury or medical emergency event.

Looking beyond, and to its credit, Correctional Service of Canada has seen improvements in the delivery of acceptable standards of care in some areas. This is in large part due to pressure and criticism from multiple community sources, and legal actions intended to bring practice in line with policy. Provincial agencies don’t get the same scrutiny, and a lot of work is waiting for dedicated advocates at that level.

Nonetheless, and despite changes, most federal inmates would testify that unless they are lying in a pool of their own blood, or in cardiac arrest, or showing obvious signs of severe medical distress, the mantra is……wait, wait, wait.

We like to cite the case of a long-time federal British Columbia inmate who was diagnosed with a cancer a few years ago and given an ominous prognosis, failing proper medical response. In the end, this inmate took CSC to court to access necessary surgery. He’s alive today and living in the community.

Solutions? Next week.

MORE CARE/DON’T CARE

“……no one truly knows a nation until one has been inside its jails. A nation should not be judged by how it treats its highest citizens, but its lowest ones.” NELSON MANDELA

Picking up from last week with the fate of terminally ill inmates, there is a provision in Section 121 of the Corrections and Conditional Release Act permitting compassionate parole for the terminally ill.

Of the 542 federal prison deaths between 2007 and 2017, ill health killed 366.  These inmates might/could/should have qualified for release to community hospice care under the CCRA.  However, only four or five compassionate paroles are granted each year, and the rest died before parole boards processed decisions.  Really?  A terminally ill man or woman without palliative care, and Mickey Mouse pain management, must have a parole board decision?  (Research shows that 50 per cent of prisoners in chronic or acute pain are given nothing stronger than Tylenol 3s.)

As for MAID, Correctional Service of Canada may still not have an assisted death policy, and inmates could have to secure a compassionate parole, and then await transfer to the community before applying.  According to a CSC spokesperson last fall, there have been six requests, but only one inmate met the criteria and that prisoner was already in the community.  The inmate died before the hospital could provide the procedure.  We shouldn’t be surprised by that delay, and we shouldn’t be surprised that CSC health care would prefer that no inmate meets MAID criteria.

We should be concerned….alright, we should be outraged….that our domesticated animals have greater legal safeguards around death and dying than the men and women in our jails and prisons.

As it is, dying in prison today means dying alone, dying without best care, and dying with only a few strangers lingering in the distance.

Now, turning to health care issues for the living……..

Spokespeople for Correctional Service of Canada, and its counterparts in the provinces, have always insisted the men and women in their custody….and care….have the same access to health care that is available to us all.  What’s on paper tends to support the claim….practice and delivery say otherwise.

We’ll flesh this out next week.

HEALTH CARE/HEALTH DON’T CARE

Getting sick, getting old in our “prison industry.”

In a word, DON’T!

Canada’s provincial and federal penal systems spend tens of millions of dollars each year on health care, including funding for mental health services.

So why then do complaints about health care in our federal system, as an example, top the list of what comes to the attention of the Office of the Correctional Investigator of Canada, the country’s ombudsman for offenders? There is no equivalent for our provincial jail inmates, no at-arms-length substantive recourse, and complainants who use what processes exist are basically left blowing in the wind.

The law in Canada says that although prisoners are deprived of liberty while they are incarcerated, all other human rights remain intact. Legally, mistreatment of any kind, or lack of proper treatment, is out, and that includes an entitlement to the same access to health care as the rest of us.

Available information from Correctional Service of Canada presents a best profile of conditions affecting the health and end of life issues for CSC’s roughly 14 to 15 thousand offenders. About a quarter, around 3,500, is over 50, and in the agency’s parlance they are ‘senior citizens.’ It admits a prison environment will knock up to 10 years off life expectancies, although inmate lifestyles are a contributing factor of some significance. It doesn’t add that the consequences of inmate poor health choices are exacerbated by the difficulties is accessing institutional health care.

Award winning author Sandra Miller wrote “Our aging prisoners deserve proper health care” for the Globe and Mail last October, noting she’d never considered the way prisoners die until she attended a conference on end of life issues last fall.

The number of older prisoners will rise with time and most who die in custody succumb to cancer, heart attacks or liver failure. She asks why we should care “if an inmate old enough to be somebody’s grandparent dies in a cell without adequate medical treatment, access to appropriate palliative care or medical assistance in dying? I think there are three reasons: compassion, equality and autonomy.”

…….continuing next week……….

“…..no one truly knows a nation until one has been inside its jails. A nation should not be judged by how it treats its highest citizens, but its lowest ones.” NELSON MANDELA

Moral courage is a rarer commodity than physical courage

This is another narrative composed by Brennan Guigue while in the Toronto South Detention Centre in 2016. This was written in late February and early March, and underscores our folly in supporting a multi-billion dollar a year self-perpetuating and failed prison industry.

My life has been filled with pain, mistrust, and lies. Early on it was mostly ‘people’ offering me “things” for my own good with one hand…., and ‘slapping’ me with the other. I always fell for the ruse due to my need for acceptance and love/friendship. However, I soon developed a mistrust of authority and decided that I needed to look out for myself. My attitude was that most people just wanted whatever they could get from ‘you’, so why shouldn’t I?

I still felt the need for acceptance and all that, but it was significantly less of a feeling than before….actually, I’m not sure that’s true.

Even today it is still a very strong desire/need within myself. So much so that I often get into trouble because of it. I developed anger/behavioural problems early on as a result of being raped and forced to perform sexual acts by my biological father. I truly believe that had I been treated as a ‘sick’ child rather than a ‘bad’ child….I would NOT be where I am today.

The Crown Attorney talks about a Dangerous Offender application on the basis that……., there’s no place for someone who poses an undue risk like me in society. I ask you….how am I supposed to have the proper skills to function in any particular environment when I have NEVER truly felt a part of said ‘environment’?!

I cannot recall EVER not feeling like an outsider, always ‘looking in’. As a child, my favourite t.v. show was The Little House on the Prairie. Why…? Because, Mr. Ingalls was ALWAYS there for his children. He even took in a ‘wayward’ boy, and adopted him as his son…., was firm but loving.

Even at 10, 11, 12 years of age, I knew what was missing in my life. That knowledge did not help my outlook on life because I didn’t have the knowledge of how to fill that gap. I wanted a relationship with my dad SO bad that my mind repressed (overlooked) the abuse from my early years. The problem there was that he didn’t care about me enough to be around.

Of course that didn’t bother me whenever he did come around because I was so busy thinking how ‘cool’ he was – and how I desperately needed to prove that I was worthy of his love – that I forgot about all the rest. Not that I remembered the abuse at that age; that didn’t begin to come to light until my memories began unlocking themselves around age 21.

After he’d leave with promises to return, I’d be SO happy and proud to have him as my dad that my behaviour would excel. My grades/behaviour at school would drastically improve……, I was euphoric. Bliss.

But, time after time he’s let me down, and the anger would return and perhaps that’s why ‘those’ around me failed to see my pain. To think I was ‘bad’ rather than sick. Period of exceptional – gentlemanly – behaviour mixed with exemplary grades were not beyond my capabilities, and so no one bothered to acknowledge the need for therapy.

Of course, not having the trust in others nor the understanding of what was ‘wrong’ with me, coupled with my me-against-the-world attitude…., I could not ask for help. How could I….? From who….? Mom? She was a ROCK. STRONG. Sacrificing herself – while having issues of her own – in order to provide for three children could not have been easy for a single native woman on welfare.

However those same qualities that helped her – and by proxy, us – to survive prevented her from being the loving, cuddly mother who I could turn to. I now realize that she was my reference guide on how to survive-on-your-own. Her love – when it showed itself – was more like that love one shares with a good buddy.

The ONLY time I ever cried in front of her was whenever she was ‘tanning my behind’, which ceased when I was 12. I was too big (5’7”, 150lbs), it no longer had an effect on me anyway. The last time I was sent to my room for stealing a bag of weed and $40 from one of her friend’s house – to await my ‘whoopin’, – I ran away. At 12 years of age, I survived for 3½ weeks on the street before getting picked up by Hamilton cops and sent back home. That’s when my mom told me she wasn’t gonna bother with the strap anymore.

My father was still coming around every now and then, but was less and less because he was often involved with criminal endeavors which took him in and out of prison (dope selling and the violence associated). Whenever he did come around, he was distant and….., ‘overly generous’, would be the best way to describe him. I didn’t recognize his demeanor until well into adulthood (30s). It was his guilty conscience, the shame he felt about what he’d done to me….and the fear of confrontation which fuelled his generosity and buddy buddy attitude.

When he went to prison I was 15 (1985) and I became enraged at society, the cops, and anyone else in an authoritative capacity for ‘taking my dad away.’ In my sick, twisted sense of loyalty, I could not see that he never deserved such dedication from me….he hadn’t earned it as a father should.

In truth…., I had never ‘had’ him, to be taken away. As the dreams of my childhood drifted further and further away, I sought acceptance from any source I could. This often led me to hang out with older, more ‘seasoned’ bad kids…., even a few young adults. I began doing whatever they did, b & e’s, theft, drugs (did my first shot of cocaine with a needle at 16 with a 22 year-old junkie, Mario).

This was the end of my childhood….my innocence had been stolen loooong before. I just didn’t know it.

The only way to describe the next several years is to say that I drifted from place to place……from ‘being’ to being lost. I soon found myself in Toronto at age 18, again living with ‘unsavoury’ people. On the street doing dope – crack……, thinking I was ‘free’. This was clearly an illusion as I know now that I’ve always been in ‘prison’…, never truly ‘free’.

So I continued like this – becoming an addict, getting in wherever I could fit in, and living with an unconscious sense of self-loathing. One thing I do know is this…..nobody ever hurt me past the age of 12 more than I hurt myself.

When my father was sent to jail when I was 15 years old, I thought – in some maladaptive way – that it was somehow my fault. That, if I had been better behaved then he would have tried harder to be a better person….., a better father.

Yes, I was mad at the world, hated the ‘system’…., but, unwittingly the only one I could see to make suffer was myself. -Rewind-

I should point out some ‘truths’ as they are so that I don’t seem to be “self-pitying”. There were periods in my life where I may have been ‘saved’. From ages 13 to 16 there were a series of CAS interventions (if one can call them that), emotional treatment facilities, group homes, foster care placements, etc. In fact there was so much intervention from CAS through my entire life until the age of 17 that I had been to 18 different schools! In spite of that, I was only one year behind in my studies.

So, what went wrong you ask?

Well….., my anger issues were never properly addressed. Two of the five CAS/Family Court placements were mentally and physically abusive, and I witnessed emotional and sexual abuse. You must understand that it was the 80s. Many of the problems and deficiencies people recognize today were much more prevalent then….., and much less acknowledged back then.

 

……….END OF PART ONE.

The POLICING file – Farewell & Good Luck?

Police, policing, police culture, police budgets get lots of media coverage. Criticism of police, policing, police culture and police budgets get lots of attention. Support for police, policing, police culture and the police budget is front and centre, too.

One deficit is news of the outcomes of the many legal actions in Canada against police. Oddly, we almost never see a suit go to open court; settlements are the usual resolution, and non-disclosure clauses are standard. Most often, we do not even know settlements have been reached. Intentional suppression? And get this, these are our tax dollars at play, and we’re not entitled to an accounting.

There are occasional disclosures of the millions paid over periods of years by our governments to satisfy these suits. But, it takes the persistence of journalists and their employers to source this information, and a willingness to risk the displeasure of powerful offices.

What is most striking is how little impact these legal actions have. Yes, it seems Toronto police officers must now be taking public relations courses, but to what end? And yes, we believe there are people in public service dedicated to supporting best practices. Nonetheless, police culture must be entrenched in the status quo and beyond any easy redemption.

We contest turnoverarocktoday’s simplistic labeling as anti-police, but with so many voices in the arena already, we also believe our resources are better directed elsewhere. Our prison industry is so heavily shrouded against the public eye as to invite suspicion of wide-spread malpractice, for instance. More attention is warranted there.

John Sewell’s Toronto Police Accountability Coalition, journalist/activist Desmond Cole and his supporters in this city, and the Canadian Civil Liberties Association cover policing extensively. The African Canadian Legal Clinic continues to operate in spite of funding setbacks, and the Ontario Human Rights Commission has just called a public interest inquiry into racial profiling by Toronto Police. There are many others.

We’ll leave this work to them, but will keep watch, update files, and post a ‘policing’ comment when compelled. As with anything, anywhere, and at any time, the biggest impediment to change is the missing voices of the masses.

Let’s move on.